• According To Plan

    Identifying your birth care preferences can instill confidence about having a baby and help you deal with the unexpected.

    By Jaime Rochelle Herndon

    512042421Birth plans: A contradiction of sorts? After all, what could be more unpredictable and uncontrollable than childbirth? But before you throw the baby out with the bathwater, so to speak, it’s worth taking another look at why birth plans can be an important tool for pregnant moms, especially first-timers.

    Birth plans originated as a way to help expectant mothers prepare for the physical and emotional work of childbirth, and to document their preferred choices before the actual moment of birth, which can be overwhelming, and, admittedly, not always conducive to clear-headed decision-making. Birth plans were also initially a way to communicate with your labor team about your preferences of care for you and your baby. These functions are still applicable, but today the birth plan tends to be a lot more flexible—in fact, the term “birth plan” is a bit of a misnomer. Birth plans can be better thought of as a set of ideals or general guidelines for what a woman wants for her birth experience, with the knowledge that things can change at any time.

    Essentially, what a birth plan represents is more like a set of “preferences,” says Jada Shapiro, a local mom, doula, and co-founder of Birth Day Presence—a childbirth education center with locations in SoHo and Park Slope.

    “[The birth plan] can have two objectives,” Shapiro says. “Writing a birth plan can help the expectant woman clarify what is important to her during the birth. This document is also very useful when a mom-to-be wants to be sure her care provider is on the same page as she is about the birth. It allows a clear conversation to happen between the mother and the care provider about what both parties expect.”

    Domino Kirke and Lindsey Bliss, two of the doulas and co-founders at Carriage House Birth, a Brooklyn-based doula collective, agree with Shapiro’s perspective.

    “I had more of a wish-list than a birth plan,I had very basic bullet points,” Kirke explains. “I started off having a home birth and ended up having to have a lot of interventions, a transferring of care [because] very unexpected things that I could have never have foreseen happened. I think a lot of people throw out birth plans because birth is so unpredictable, and if you don’t stick to the birth plan, some women feel a sense of failure.”

    So what if the birth doesn’t go as expected? Is the plan useless? Not at all—the plan encompasses much more than the actual birth, and when you’re caught off guard, it’s even more important to have an anchor or direction.“I really like for our clients to have a good sense of what they want, especially once the baby’s out. Post-partum: This, this, this, and this,” Kirke says.

    Bliss adds: “Because even if a baby’s born by an emergency C-Section, they can still be allowed—if baby’s healthy—to say: ‘I don’t want my baby to be bathed, I want to exclusively breastfeed.’”

    Sometimes, even accomplishing just one facet of the plan is enough. Bliss mentions a client whose birth plan went completely askew when she gave birth prematurely. The one thing she wanted to save was her placenta, so that it could be encapsulated, which Bliss was able to do. This made the woman feel so empowered that at least one part of her birth plan was achieved, despite the fact that the actual birth experience was not her ideal.

    Especially in New York City, it can be helpful to have a birth plan to add a layer of advocacy to your birthing experience. “New York City has a high level of routine intervention,” Shapiro says. “For women who really hope to avoid this, discussing your birth plan ahead of time with your care provider helps to ensure you have picked a care provider who doesn’t jump to medical intervention unnecessarily.” If you find out that you and your provider disagree on a fundamental level, you can switch care providers to someone who is more aligned with your vision.

    “I think women who even have a vague sense of what they want, like: ‘I know I don’t want them to clamp the cord until it’s stopped pulsating,’” Kirke explains. “[These women] just have a louder voice. If they say: ‘I really want to do this,’ the odds of them getting it are higher, you know? It’s a manifestation thing.”

    Some women may get nervous when sharing their birth plans with their doctors and nurses—the reaction from hospital staff to birth plans can be anywhere from gracious to hostile. Negative reactions usually stem from previous experiences with rigid, inflexible plans that failed to consider deviations from what was expected, which is why it’s important to pay attention to the language used in the plan and allow for flexibility.

    Kirke admits that she has experienced a variety of reactions from hospital staff regarding birth plans. “Having a doula telling you that your OB should read your birth plan,or at least look at it, is really helping new moms,” she says. “Even if an OB looks at a birth plan, whether they end up sticking to it or not…they’re caring for you, just by acknowledging that you have a birth plan…and it’s amazing what acknowledgement can do.”

    At the end of the day, your birth plan should account for all the possible scenarios and outline your requests for each one—in fact, as Bliss points out, having a birth plan can be most beneficial when things don’t go according to plan—while still explaining what the idea outcome would be. A birth plan isn’t a magic document that will ensure a perfect birth experience, but it can be a helpful communication tool and a good way to explore what you want for your labor, delivery, and post-partum care.

     Inspired to write your own birth plan? Check out our guide here

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